2021—2022年徐州市HIV-1感染者治疗前基因分型及耐药特征  

Pretreatment genotyping and drug⁃resistant characteristics among HIV⁃1 infected individuals in Xuzhou City from 2021 to 2022

作　　者：邢文书 周莹[2] 管雅笛 马丽丽 张心驰 童晶[1] 吴畏畏 XING Wen⁃shu;ZHOU Ying;GUAN Ya⁃di;MA Li⁃li;ZHANG Xin⁃chi;TONG Jing;WU Wei⁃wei(Xuzhou Municipal Center for Disease Control and Prevention,Jiangsu Xuzhou 221000,China;不详)

机构地区：[1]徐州市疾病预防控制中心,江苏徐州221000 [2]江苏省疾病预防控制中心

出　　处：《江苏预防医学》2024年第5期611-614,共4页Jiangsu Journal of Preventive Medicine

基　　金：徐州市科技局项目课题(KC23227)

摘　　要：目的了解2021—2022年徐州地区新发现且未接受抗逆转录病毒治疗HIV-1感染者基因型流行情况,分析耐药影响因素。方法采集2021—2022年徐州市524例新发现HIV-1感染者治疗前抗凝全血样本,检测初次CD_(4)^(+)T淋巴细胞(CD4细胞)数、初始病毒载量;扩增HIV-1基因区片段(pol区)并测序分析。结果524例HIV-1感染者成功分型446例,检出14种基因亚型,主要为CRF01_AE(占43.05%)、CRF07_BC(占34.98%)、B(占7.85%),CRF01_AE亚型多数经同性传播(占60.42%),不同传播途径基因亚型构成差异有统计学意义(χ^(2)=16.73,P<0.01)。总耐药率为10.99%(49/446),以单一的非核苷类反转录酶抑制剂耐药为主,耐药率为7.40%(33/446)。最常见的耐药突变位点是K103N(占40.82%)、Q58E(占20.41%)。多因素分析显示,相比于CRF01_AE亚型,CRF55_01B亚型(OR=9.13,95%CI=1.93~43.24)和CRF85_BC亚型(OR=17.82,95%CI=2.09~152.26)的新发感染者耐药风险较高(P值均<0.05)。结论徐州市HIV-1感染者治疗前耐药水平较高,CRF55_01B和CRF85_BC亚型更易发生耐药,需加强对HIV-1基因型的监测。Objective To investigate the genotypes among newly diagnosed,antiretroviral treatment⁃naïve HIV⁃1 infected individuals in Xuzhou City from 2021 to 2022,and to identify factors affecting the risk of drug resistance.Methods Anticoagulated whole blood samples were collected from 524 newly diagnosed HIV⁃1 infected individuals prior to treatment in Xuzhou City from 2021 to 2022,and the initial CD_(4)^(+)T lymphocyte(CD4 cell)counts and initial HIV viral load were detected.The HIV⁃1 pol gene was amplified,and the amplified product was sequenced.Results Successful genotyping was done among 446 out of the 524 HIV⁃1 infected individuals,and 14 HIV⁃1 genotypes were identified,with CRF01_AE(43.05%),CRF07_BC(34.98%)and B(7.85%)as dominant genotypes.The CRF01_AE subgenotype was predominantly transmitted through homosexual exposure(60.42%),and there was a significant difference in the transmission route(χ^(2)=16.73,P<0.01).The overall prevalence of HIV⁃1 drug resistance was 10.99%(49/446),and resistance to non⁃nucleoside reverse transcriptase inhibitors(NNRTIs)alone was dominant,with 7.40%(33/446)prevalence of NNRTIs resistance.The two most frequent drug⁃resistant mutation sites were K103N(40.82%)and Q58E(20.41%).Multivariate analysis showed that the risk of drug resistance was higher among newly diagnosed HIV⁃1 infected individuals with the CRF55_01B[odds ratio(OR)=9.13,95%confidential interval(CI):(1.93,43.24)]and CRF85_BC subgenotypes[OR=17.82,95%CI:(2.09,152.26)]relative to with the CRF01_AE subgenotype(both P values<0.05).Conclusions The pretreatment prevalence of drug resistance is high among HIV⁃1 infected individuals in Xuzhou City,and drug resistance is more likely to emerge among those with CRF55_01B and CRF85_BC subgenotypes.Monitoring of HIV⁃1 genotypes should be intensified.

关 键 词：艾滋病 HIV-1 基因亚型 治疗前耐药 耐药基因突变 

分 类 号：R512.91[医药卫生—内科学]